1.Non-O1, non-O139 Vibrio cholerae bacteraemia in splenectomised thalassaemic patient from Malaysia.
Deris ZZ ; Leow VM ; Wan Hassan MN ; Nik Lah AZ ; Lee SY ; Siti Hawa H ; Siti Asma H ; Ravichandran M
Tropical Biomedicine 2009;26(3):320-325
Vibrio cholerae infection is mainly caused acute diarrhoea disease. Bacteraemia due to non-O1 V. cholerae is rare and mainly reported in liver cirrhotic patients. We report one case of non-O1 V. cholerae bacteraemia in splenectomised thalassaemic patient who presented with septic shock secondary to abdominal sepsis. She had undergone emergency laporatomy and was managed in the intensive care unit for nine days. She was treated with meropenem and doxycyline and discharged well after fourteen days of admission. The V. cholerae was identified by API 20NE, serotype and polymerase chain reaction showed as non-O1, non-O139 strain. Besides known cholera-like toxin and El Tor hemolysin, with increasing reported cases of V. cholerae bacteraemia, there is possibility of other virulence factors that allow this organism to invade the bloodstream.
2.Are Dropped Bone Grafts Safe to be Re-used? - An Experimental Study Comparing Efficacy of Chlorhexidine, Povidone-Iodine and Alcohol
Mat-Salleh MF ; Sadagatullah AN ; Ibrahim MY ; Abdul-Aziz I ; Wan-Abdullah WA ; Maning N ; Md-Hassan MN ; Ab-Rashid MR
Malaysian Orthopaedic Journal 2021;15(No.2):70-76
Introduction: A dilemma arises when a bone graft or
fracture fragment is accidentally dropped on the operation
theatre floor and becomes contaminated. This study aimed to
determine the efficacy of simple and readily available
antiseptic solutions in disinfecting contaminated bones.
Materials and methods: This experimental study involved
225 bone specimens prepared from discarded bone
fragments during a series of 45 knee and hip arthroplasty
surgeries. The bone fragments were cut into five identical
cubes and were randomly assigned to either control (positive
or negative), or experimental groups (0.5% chlorhexidine,
10% povidone-iodine or 70% alcohol). The control negative
was to determine pre-contamination culture. All bone
specimens, except the control negative group were uniformly
contaminated by dropping on the operation theatre floor.
Subsequently, the dropped bone specimens except for the
control positive group, were disinfected by immersing in a
respective antiseptic solution for 10 minutes, before
transported to the microbiology laboratory for incubation.
Results: The incidence of a positive culture from a dropped
bone fragment was 86.5%. From the 37 specimens sent for
each group, the incidence of positive culture was 5.4% (2
specimens) after being disinfected using chlorhexidine,
67.6% (25 specimens) using povidone-iodine and 81.1% (30
specimens) using alcohol. Simple logistic regression analysis
demonstrated that chlorhexidine was significantly effective
in disinfecting contaminated bones (p-value <0.001, odd
ratio 0.009). Povidone-iodine and alcohol were not
statistically significant (p-value 0.059 and 0.53,
respectively). Organisms identified were Bacillus species
and coagulase negative Staphylococcus. No gram-negative
bacteria were isolated.
Conclusion: A total of 0.5% chlorhexidine is effective and
superior in disinfecting contaminated bones.